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Too little, too late.
Dr. Davis, a retired clinician and emergency medicine professor, predicts shortfalls by hundreds of thousands in the number of ventilator breathing machines needed. Hospitals will need to expand into tents and commandeered hotels.
Medical staff will be stretched to the breaking point. "Treating people in halls" -- a stressful situation Davis experienced in his ER career after multiple-casualty car accidents -- will seem like a luxury.
In the following interview with Dr. Davis, he lays out the grim arithmetic predicting the coming coronavirus health crisis.
MedicineNet: Do you think the measures currently in place in the U.S. will get the infection under control better than in Italy where hospitals are overwhelmed and breathing machines are being rationed?
Dr. Davis: Unless they do something extraordinary, I think what is going to happen is we will run out of hospital beds in hospitals proper, and they will have to go into things like tent treatments, or as China did and build new places and take over buildings to house patients.
In my professional experience, patients from large accidents have had to be treated in hospital hallways, which is very difficult and hard on the medical personnel. Ideally you have one or two nurses for a critical care patient. You run out of staff.
This type of experience (with COVID-19) is something I've never had.
MedicineNet: Public health experts want to "flatten the curve," or keep the number of infections low enough that they don’t overwhelm the healthcare system. Can you explain what epidemiologists are talking about when they say this?
Dr. Davis: Unfortunately, the curve is still liable to overwhelm the hospitals, in terms of their beds and equipment. Essentially, what you need to do is understand the data points.
The total number of ICU beds in the United States is about 100,000. At any given time, about two of three ICU beds are being used, so that leaves only about 33,000 in the U.S.
Then, you take the population of the U.S. -- 331 million.
If 1% of that population is affected by coronavirus, that'll be 3.3 million people.
Based on current information, about 80 percent of the people infected will be fine, with mild symptoms and will recover nicely.
But that leaves anywhere from 16% to 20% of the rest of the population cases who needs hospital beds.
So multiply 0.16 times 3.3 million, and it gives you the number of hospital beds -- and these are ICU/CCU beds you'll need. (These are the beds used in departments with the most specialized life support equipment, plus extra staff to care for the sickest patients).
It comes up to approximately 530,000 ICU beds needed.
Ramping that up, if 10 percent of the U.S. population were to be infected with coronavirus, that'll be approximately 33 million infections, times the percent who need the hospital beds -- let's stay with 16% to be conservative.
That number is now 5.3 million ICU beds needed.
MedicineNet: So there could be a shortage of hospital beds in the hundreds-of-thousands, if not millions. Are there enough breathing machines for all the COVID-19 coronavirus patients who need them?
Dr. Davis: Based on a 1% infection rate, if 5% of those infected patients require a ventilator, that means we would need, theoretically, about 165,000. There are not near that many breathing machines in the U.S.
MedicineNet: What do you think of "social-distancing" as a means to end the coronavirus outbreak? Should we practice this? For how long? Any other coronavirus prevention tips?
Dr. Davis: I think it is a good strategy. We should practice it as long as the virus is circulating in high numbers. It's the best thing to do.
Another thing you should do is 20-second hand washing. You're probably going to have to go out from time to time to get groceries and other supplies. When you do go out, maintain that distance (roughly six feet away from others). Try not to have any contact.